乳腺癌不同分子分型的临床病理特点及预后分析  

Clinicopathological characteristics and prognosis of different molecular types of breast cancer

作　　者：刘钟芬 陈创[1] 姚晓莉[1] 孙圣荣[1] 

机构地区：[1]武汉大学人民医院乳腺甲状腺外科,430060

出　　处：《中华医学杂志》2016年第22期1733-1737,共5页National Medical Journal of China

基　　金：国家自然科学基金（81471781）

摘　　要：目的观察LuminalA型、LuminalB型、人表皮生长因子受体2阳性（HER2型）和三阴型乳腺癌的临床、病理特点及预后。方法收集武汉大学人民医院于2011年1月至2012年11月收治的102例原发女性乳腺癌患者的临床资料，回顾性分析各亚型乳腺癌的临床、病理特点，以及与其预后的关系。结果各亚型比例为LuminalA型27．5％，LuminalB型35．3％，HER2型14．7％，三阴型22．5％。年龄为22～75岁，中位年龄48．0岁。患者均行乳腺癌手术，98例术后进行化疗／内分泌治疗＋赫赛汀靶向治疗（96．1％）。不同亚型乳腺癌的肿瘤大小、组织学分级、淋巴结转移数目差异均有统计学意义（均P〈0．05）。两两比较发现，HER2型肿瘤≤2em的比例（4例，26．7％）有小于LuminalA（20例，71．4％）或三阴型（16例，69．6％）的趋势，但差异无统计学意义（P=0．009〉0．008，P=0．019〉0．008），HER2型组织学Ⅲ级的比例（8例，53．3％）有大于LuminalA型（23例，82．1％）的趋势，差异无统计学意义（P=0．039〉0．008）。三阴型的无淋巴结转移的比例（7例，30．4％）有小于HER2型（7例，46．7％）或LuminalB型（17例，47．2％）的趋势，差异无统计学意义（P=0．019〉0．008，P=0．016〉0．008）。不同亚型患者的发病年龄、是否绝经、手术方式、肿瘤家族史、复发转移危险度之间差异均无统计学意义（P〉0．05）。LuminalA型第3年总生存率为100％，第1、2、3年无事件生存率均为92．9％，LuminalB型总生存率为100％，第1、2、3年无事件生存率均为97．2％，HER2型总生存率为100％，第1、2、3年无事件生存率分别为100％、100％、93．3％，三阴型第1、2、3年总生存率分别为100％、95．7％、95．7％，第1、2、3年无事件生存率分别为95．7％、91．3％、90．0％。是否三阴型、复发转移危险度、年龄、是否绝经、肿瘤大小、Objective To investigate the clinicopathological characteristics of 4 subtypes of breast cancer, Luminal A, Luminal B, human epidermal growth factor receptor 2 （ HER2 ） , triple-negative and their associated prognostic factors. Methods The clinical characteristics and prognosis of 102 patients with breast cancer who treated in Wuhan University Renmin Hospital from January 2011 to November 2012 were retrospectively analyzed. Results The proportion of each subtype was Luminal A 27.5 %, Luminal B 35.3%, HER2 14. 7%, and triple-negative 22. 5%. The age range was from 22 to 75 years old, with median age of 48.0 years old. All patients underwent surgery and 98 cases were also treated with chemotherapy/endocrine ＋ Herceptin therapy （ 96. 1% ） after surgery. The tumor size, histological grade, and lymph node metastasis had significant difference in different subtypes of breast cancer （ P 〈 0. 05 ）. Further analysis showed the proportion of HER2 tumor ≤2 cm （4, 26. 7% ）had a tendency of smaller than that in luminal A（20, 71.4% ） or triple negative（ 16, 69.6% ） （P =0.009 〉0.008, P =0. 019 〉0.008）. Histological Ⅲ grade proportion in patients with HER2 subtype （8, 53.3% ） was in greater tendency than that with Luminal A subtype （ 23, 82. 1% ） （ P = 0. 039 〉 0. 008 ）. The proportion of patients with no metastatic lymph nodes in triple negative subtype（7, 30. 4% ） had a tendency of smaller than that in HER2 subtype （7, 46. 7% ） or Luminal B subtype （ 17, 47. 2% ） （P = 0. 019 〉 0. 008, P = 0. 016 〉 0. 008 ）. There were no significant differences in age of onset, menstruation status, operation, family cancer history, and the risk of recurrence and metastasis in different subtypes （P 〉 0. 05 ）. In Luminal A subtype, three-years overall survival rate was 100% , and one-, two-, three-year event-free survival rate were all 92. 9%. In Luminal B subtype, three-year overall survival rate was 100%, event-free survival rate at one-, two- and three-year were a

关 键 词：乳腺肿瘤 分子分型 病理学 外科 预后 

分 类 号：R737.9[医药卫生—肿瘤]